Thyroid dysfunction is frequent in pregnant women and is often associated with an increased risk of adverse maternal and fetal outcome. In the present work, thyroid function of pregnant women from Benin republic was studied. Two hundred forty (240) pregnant women, without thyroid disease history, have been included in the study. A blood sample was drawn for measurement of TSH, free T3 and free T4 serum levels. From the first to the third trimester, plasma levels of free T3 and free T4 decreased when plasma levels of TSH increased. Using recommendations of the 2011 American Thyroid Association (ATA) guidelines, thyroid dysfunction was observed in 24.17% of subjects. Hypothyroidism was present in 22.50% of subjects with 19.17% of subclinical hypothyroidism, 0.83% of overt hypothyroidism and 2.50% of hypothyroxinemia and hyperthyroidism was observed in 1.67% of subjects. An increase from 15.52% to 28.07% was observed in the frequency of hypothyroidism from the first to the third trimester of pregnancy. When an upper cut-off value of 4 mU/L was used for TSH, as recommended in the 2017 ATA guidelines, prevalence of thyroid disorders was 14.58% with 12.91% of hypothyroidism but no hypothyroidism was observed in women in the first trimester of pregnancy. A rise in hypothyroidism frequency was observed when pregnant women age increased. Hypothyroidism was very common in pregnant women in Benin. To allow accurate assessment of thyroid status in pregnant women in Benin, pregnancy specific range for plasma level of TSH and thyroid hormones should be established.

Objective: Study the fetal-maternal and neonantal prognosis of sickle cell pregnancies managed in Cotonou's hospitals (R. Benin). Material and methods: This is a descriptive study on retrospective data from January 2008 to December 2018. The maternities of the Lagoon Mother and Child Hospital and University (CHU-MEL) center and of the CNHU/HKM gynecology and obstetrics university clinic had served as a framework. Complete patients records were analyzed. Included were pregnant women or delivered at 28 weeks of amenorrhea (AW) or beyond, sickle cell disease SS or SC confirmed by hemoglobin electrophoresis. Sociodemographic, clinical, therapeutic, and fetal-maternal and neonatal prognosis were analyzed. EPI DATA 3.1 and SPSS 2.0 software were used to analyze our data. The difference is significant for a p-value ≤ 5%. Ethical and professional standards and rules were respected. Results: The delivery of a patient suffering from sickle cell disease represented 0.82% of births. The SS phenotype was observed in 27.3% (n=105) versus 72.7% (n=279) of SC (p=0.000). A history of obstetric complications was noted in 56.8% (n=218). The course of the current pregnancy was marked by obstetric complications in 97.4% and the most important were: the threat of premature delivery (28%) and the vaso-occlusive crisis (19.5%). The caesarean was performed in 92% of sickle cell patients. Premature delivery was observed in 60% with 6.3% very premature (28-33AW). It was registered 91% (n=352) live births, 48% (n=169) hypotrophs, 60% premature, 1.1% (n=4) intrapartum deaths and 8% (n=4) intrapartum deaths and 8% (n=31) deaths in utero. Perinatal mortality represented 9%. The after-effects of childbirth were complicated in 12% (n=46). The puerperal infections (32.6%), hypertension (28.2%) and its complications and severe anemia (19.2%) were the most common complications. Five (5) maternal deaths were deplored, ie a mortality rate of 1420 maternal deaths per 100,000 live births. Conclusion: In Benin, pregnancy and delivery of sickle cell disease are at high risk of fetal, maternal and neonatal mortality. Caesarean section was almost routine in this group. The practice of transfusion exchange or bleeding may improve prognosis.

Introduction: Spontaneous fertility after myomectomy for pregnancy desire remains a concern. Objective: Appreciate spontaneous fertility after a myomectomy for pregnancy desire. Methods: This was a descriptive and analytical study to collect retrospective data on cases of myomectomy pregnancy desire realised between 2016 and 2020 in the university maternity wards of Cotonou. All myomectomy records for desire for pregnancy were identified. The post myomectomie fertility related data and the clinical characteristics influencing the occurrence of pregnancy and its outcome after myomectomy were analyzed with regard to the rules of professional conduct and ethics. Results: On 188 myomectomies performed for desire of pregnancy, 102 had been analyzed. The mean age was 34 years ± 5.7. Nulligest and nulliparous were the most numerous in the respective proportions of 39.2% and 71.6%, and 16.7% (n=17) had a history of polymyomectomy. Fertility after myomectomy was observed in 16.7% (n=17) of cases. The mean time to return to fertility (pregnancy) after myomectomy was 27 months. Alcohol addiction (p=0.00), gestality (p=0.01), myoma size (p=0.00) and adenomyosis (p=0.00) had an negative impact on the time to onset pregnancy after myomectomy. Of 17 pregnancies recorded after myomectomy, 11 (64.7%) progressed normally with term delivery and 5 spontaneous abortions (29.4%) were recorded. One (1) pregnancy was ongoing at the time of the survey. Planned caesarean section (n=9) was the most frequent mode of delivery. Eleven (11) newborns were welcomed and the diaper suites were simple. Conclusion: Spontaneous fertility after myomectomy remains low in our series. Factors with a negative impact on fertility must be taken into account.

Objective: Study the epidemiological and anatomopathological characteristics of breast tumors of young woman.Patients and Methods: This was a retrospective and evaluative cross-sectional study of patients treated for a breast tumor between January 1, 2015 and December 31, 2019 in two hospitals in Cotonou. All the complete files of patients under the age of 40 treated for breast tumors of whatever nature were listed. The patients were recalled for clinical and / or radiological evaluation. The epidemiological and histological characteristics of breast tumors were analyzed. Results: The study involved 231 breast tumors including 12 cancers (5.2%) and 219 benign tumors (94.8%). The mean age of the patients was 25.7 years±7.2. Self-examination was the most common discovery (81%). The average consultation time was 6.4 months. The right breast and the upper-external quadrant were the most affected in 53% and 31.1%, respectively. Fibroadenomas (70.7%) and invasive ductal carcinomas (9/12) were the most frequent. Obesity and a family history of breast cancer were associated with the occurrence of breast cancer in young women (p ≤ 5%). The relative risk of developing breast cancer was practically zero before the age of 30. Benign breast tumors spontaneously regressed in part or in whole in 35.3% of cases (n=55), they were stable in 44.8% of cases (n=70) and increased in volume in 19.8% of cases (n=31). The age of diagnosis strongly influenced the evolution of tumors in the young woman in Cotonou (p=0.02). In 56% of cases, breast tumors diagnosed before the age of 20 spontaneously resolved in part and in whole. The breast cancer case fatality in women under 40 was 11.1%. Conclusion: Breast tumors in young women are mostly benign. More than half of these tumors diagnosed before the age of 20 resolve spontaneously. The risk of breast cancer is virtually zero before the age of 30 in our series.

Objective: To evaluate the risk of preterm delivery with vaginal touch in opposition with transvaginal ultrasound in pregnant women who present signs and symptoms of threatened preterm labour. Methods: A prospective study was conducted with descriptive and comparative aims at the University Hospital of Porto-Novo, Benin Republic between 1 March and 31 August 2016. Every pregnant woman admitted to the emergencies of the maternity between 28 and 34 of WA (weeks of amenorrhoea) and attended for preterm delivery risk with intact membranes was included. The risk of preterm delivery was evaluated using vaginal touch and ultrasound examination of cervical length. Results: The risk of preterm delivery was obvious and identical with the cervical dilatation ≥2 cm when the vaginal touch was applied [RR 2.34 IC 95% (1.71 -3.20)] and ultrasound examination of cervical length <25 mm [RR 2.44 IC 95% (1.43 -4.16)]. The cervix obliteration was not statistically linked to preterm delivery. The ultrasound examination of cervical length had a better sensitivity (87.76%) and a negative predictive value (81.54%) against 59.18% and 74.68% respectively for cervical dilatation at vaginal touch. Bishop score also had a better specificity with the one of the ultrasound examination of cervical length (79.11% vs. 33.54%) whereas both of them had almost identical negative predictive value (81.17% vs. 81.54%). Conclusion: Vaginal touch was also as relevant as transvaginal ultrasound while evaluating the risk of preterm delivery. For the lack of ultrasound in emergency rooms, a good physical examination would be sufficient by its own to decide of an adequate management when there is a threat of preterm delivery.How to cite this paper: Ogoudjobi, O.M., Tshabu-Aguemon, C., Lokossou, M